超声造影在评价青光眼视神经血液供应中的临床应用  

Ocular haemodynamic in patients with glaucoma measured by contrast-enhanced ultrasound

作　　者：韩丽楠 宋武莲[1] 孙静波[1] 原慧萍[1] HAN Linan;SONG Wulian;SUN Jingbo;YUAN Huiping(Department of Ophthalmology,The 2nd Affiliated Hospital,Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院眼科,哈尔滨150086

出　　处：《眼科学报》2021年第6期449-456,共8页Eye Science

摘　　要：目的:应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况,探讨血流变化与青光眼的关系。方法:选取2012年12月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primar y angle closure glaucoma,PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma,POAG)患者8例(10只眼),分别设为PACG组和POAG组;同时,选取10例10只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查,观察眼动脉(ophthalmic ar tery,OA)、视网膜中央动脉(central retinal artery,CRA)、睫后短动脉(short posterior ciliar y artery,SPCA)的血流动力学指标,包括收缩期最大血流速度(peak systolic velocity,PSV)、舒张末期血流峰值速度(diastolic peak velocity,EDV)、血流阻力指数(res i stance index,RI)、造影剂到达时间(ar r iva l time,AT)及消退时间(departure time,DT)等指标,并对结果进行统计学分析。结果:超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035),PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010);彩色多普勒测定PACG组及POAG组的OA和SPCA,以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003);同时,PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论:彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群,为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。Objective:This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma(PACG)and primary open-angle glaucoma(POAG),to investigate the association between the blood flow changes and glaucoma.Methods:Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients(20 eyes,PACG group),8 POAG patients(10 eyes,POAG group)who were diagnosed in the Department of Ophthalmology,the Second Affiliated Hospital of Harbin Medical University from Dec.2012 to Mar.2014.The normal eyes from 10 persons were selected as control group.The flow velocity of ophthalmic artery,central retinal artery,and posterior ciliary artery were observed,including the peak systolic velocity,diastolic peak velocity,resistance index,and the arrival time and departure time of the ultrasound microbubbles(SonoVue).Results:Compared to control group,the arrival time of the ultrasound microbubbles(SonoVue)of ophthalmic artery of patients with POAG increased(P=0.035),and the departure time of ophthalmic artery of patients with PACG and POAG increased(P=0.010).Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased(P=0.003).Meanwhile,the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group(P<0.001).Conclusion:The flow velocity of ocular vascular was worse than that of normal group respectively.This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.

关 键 词：彩色多普勒 超声造影 青光眼 眼部血管 血流动力学 

分 类 号：R775[医药卫生—眼科] R445.1[医药卫生—临床医学]